Addressing the Midlife Mortality Crisis: Place-Based Modeling, Trend Analysis and Policy Interventions

解决中年死亡率危机：基于地点的建模、趋势分析和政策干预

• 批准号: 10583849
• 负责人: Myron P. Gutmann
• 金额: $ 58.12万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583849
• 关键词: Address; Adult; Affect; Age; Alcohol abuse; Algorithms; Area; Attention; Businesses; COVID-19; Cardiometabolic Disease; Cause of Death; Censuses; Cessation of life; Characteristics; Child; Classification; Communicable Diseases; Communities; Complex; County; Crime; Data; Databases; Demographic Analyses; Detection; Development; Differential Mortality; Distress; Drug abuse; Economic Conditions; Economics; Employment; Event; Feedback; Foreclosure; Formulation; Future; Geography; Health Policy; Hepatitis C; Housing; Income; Individual; Inequality; Intervention; Maps; Methods; Modeling; Mortality Determinants; Outcome; Pattern; Policies; Policy Developments; Policy Research; Population; Population Sizes; Procedures; Process; Property; Records; Research; Research Personnel; Resolution; Risk; Risk Factors; Role; Rural; Rural Health; Science; Series; Social Conditions; Spottings; Statistical Data Interpretation; Structure; Testing; Time; Work; aged; design; detection method; experience; innovation; middle age; mortality; mortality risk; novel; policy recommendation; response; social disparities; spatiotemporal; statistics; suicide rate; theories; therapy design; trend; trend analysis

PROJECT SUMMARY This project will study midlife mortality trends by analyzing the local correlates and risk factors of cause of death in their place-based context between 1990 and 2021. Using cause-specific death data, sociodemo- graphic characteristics, and economic trends, the research will generate trajectories of midlife mortality risks for dynamically-derived spatial units. What makes this project innovative and significant is (1) mortality data at the block, zip code or tract level; (2) methods in spatial analysis, time series trajectory determination, and mul- tiscalar statistical analysis; and (3) an innovative and integrated approach to policy research, conducted by a team experienced in demographic analysis, multiscalar spatial and temporal statistics, and rural health policy formulation. This work responds to research and policy discussions regarding potentially-modifiable attributes of places related to rising mortality among middle-aged adults. Several cause-specific mortality trends warrant attention: rising rates of suicides, cardiometabolic diseases, and deaths due to drug or alcohol abuse, along with their interactions with select infectious diseases (e.g., Hepatitis C and COVID-19). The project has five specific aims: (1) For select U.S. states where block- or tract-level mortality data are available, researchers will create a novel micro-scale database with cause-specific mortality records and contextual data including cen- sus-based demographic data, employment and business data, property characteristics, and crime data. (2) The research makes use of an iterative algorithm to identify clusters of micro-units that have common, cause- specific mortality patterns, using community detection methods, in order to identify the most salient levels of spatial units at which processes affecting midlife mortality occur. It also assesses spatial autocorrelation to identify mortality hot- and cold-spots (spatial) and undertakes extreme event detection to identify hot-moments (temporal). (3) The project uses multi-channel sequencing to classify geographic units, for example, where population has grown or diminished, aged, or seen an increase in children, or where the economy has created wealth. These trajectories constitute a set of place-based classifications for later analysis. (4) The project’s analysis will use spatiotemporal models to estimate the effect of local-to-regional determinants of cause-spe- cific mortality in middle-aged adults, with two strategies: (A) Assess the role of different place-based determi- nants of midlife mortality, in order to evaluate theories of midlife mortality differentials and to test specific hy- potheses (e.g., economic distress). (B) Identify the optimal scale at which determinants with the greatest im- pact operate to inform policy recommendations designed to target midlife mortality for specific causes of death. (5) Designing policy interventions is fundamental to the project, which begins with a policy mapping process, and builds on the results of the multiscalar analysis to design intervention strategies targeting the determinants of mortality differentials and the characteristics of places at greatest risk of continued mortality challenges.

项目摘要 该项目将通过分析当地的相关性和风险因素来研究中年死亡率趋势 在1990年至2021年之间的基于位置的情况下的死亡。使用特定原因的死亡数据，社会 图形特征和经济趋势，该研究将产生中年死亡率风险的轨迹 动态衍生的空间单元。是什么使该项目创新和重要的是（1）死亡率数据 块，邮政编码或区域水平； （2）空间分析，时间序列轨迹测定和mul-的方法 Tiscalar统计分析； （3）一种创新和综合的政策研究方法，由 在人口统计分析，多阶层空间和临时统计以及粗略健康政策方面经验丰富的团队 形成。这项工作响应有关潜在可修改属性的研究和政策讨论 与中年成年人死亡率上升有关的地方。几种特定原因的死亡率趋势保证 注意：沿着毒品或酗酒引起的自杀，心脏代谢疾病和死亡的率上升 随着它们与某些传染病的相互作用（例如，丙型肝炎和Covid-19）。该项目有五个 具体目的：（1）对于有块或道级死亡率数据的某些美国州，研究人员将 创建一个具有特定原因的死亡率记录和上下文数据（包括CEN-）的新型微型数据库 基于SUS的人口统计数据，就业和业务数据，财产特征和犯罪数据。 （2） 该研究利用迭代算法来识别具有常见的，原因的微单元簇 使用社区检测方法的特定死亡率模式，以确定最显着的水平 发生影响中年死亡率的过程的空间单位。它还评估了空间自相关 识别死亡率热点和冷点（空间），并进行极端事件检测以识别热毛； （颞）。 （3）该项目使用多通道测序来对地理单位进行分类，例如 人口已经成长，减少，老化或发现儿童的增加或经济创造的地方 财富。这些轨迹构成了一组基于位置的分类，用于以后分析。 （4）项目 分析将使用时空模型来估计原因Spe-的局部到区域确定剂的效果 中年成年人的民用死亡率，有两种策略：（a）评估不同地点的决定的作用 - 中年死亡率的纳特，以评估中年死亡率差异的理论并测试特定的hy- potheses（例如，经济困扰）。 （b）确定最佳尺度，以最大的影响确定 协定旨在为旨在针对中年死亡率的政策建议提供针对特定死亡原因的建议。 （5）设计政策干预措施是该项目的基础，该项目始于政策映射过程， 并建立在多层分析的结果上，以设计针对确定性的干预策略 死亡率差异和最大风险持续死亡挑战风险的地方的特征。